Psychiatrists are cautiously optimistic after a small, early study revealed that a nasal spray containing the club drug ketamine appears to quickly assist in easing depression and even hinders thoughts of suicide.
“This study only had 68 people enrolled, which is a limitation, so there really needs to be larger-scale studies before being able to confidently recommend ketamine as a first-line choice,” said Dr. Matthew Lorber, a psychiatrist at Lenox Hill Hospital in New York City. Lorber was not associated with the study, which was funded by pharmaceutical company Janssen and published April 16 in The American Journal of Psychiatry.
Lorber noted that longer-term studies need to be conducted, “but ketamine is certainly an exciting option that holds a lot of promise, especially when traditional medications have failed.”
Although ketamine is likely best known as the recreational club drug “Special K,” researchers have recognized its effects in easing depression, Web MD reported.
Researchers called the study “proof-of-concept” that “intranasal esketamine may be an efficacious treatment for rapid reduction of depressive symptoms, including suicidal ideation [thoughts] in patients assessed to be at imminent risk for suicide.”
Some participants experienced side effects, including nausea, dizziness, dissociation (a sense of being disconnected from reality) and headache.
The researchers also noted that while the benefits shown in this small study were encouraging, ketamine comes with potential for abuse.
In an editorial that accompanied the study, journal editor Dr. Robert Freedman acknowledged that “protection of the public’s health is part of our responsibility as well, and as physicians, we are responsible for preventing new drug epidemics.”
Dr. Robert Dicker, who helps direct child and adolescent psychiatry at Northwell Health in New Hyde Park, N.Y., made the case that new and improved depression medications are needed.
“One must keep in mind that the prevalence of depression in our adult population is high — 1 in 15,” Dicker said. “That depression is the most common diagnosis related to suicide [and] 1 million American adults attempt suicide [each year].
“A large number of adults being treated for depression are resistant to our current treatments, so the need to develop new treatment approaches are tremendous,” he added. “The possible utility of ketamine in treating this population is an important avenue of study.”
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